Things I learned from my patients today...

[OldPsychDoc]

1) If you're celebrating your graduation by dropping acid, it's best NOT to do it at a large state fair with thousands of people, animals, and clowns present.

2) If you're immigrating from the middle east, reporting that the FBI is watching you is NOT a symptom of psychosis.

3) Delirium may be manifested by forgetting you had pizza and beginning to eat the plate.

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[Anasazi23]

Lunesta or Ambien can cause an otherwise normal person to wake up in the morning and discover that they had made enough mushroom enchiladas in the middle of the night to choke horse, which can be verified by a pile of half-eaten enchilada shrapnel left in the bed and a very messy kitchen.

 

[Anasazi23]

5) If you live in a public housing drug addict apartment building, it's best not to break down the crack dealer's door at 3am complaining of loud music while nakedly weilding a machete threatening them to shut it off lest you kill them.

 

[whopper]

SSRIs can delay orgasm as a side effect.

and some of my male patients come back to me telling me that they're so happy because now that they last for much longer, their girlfriend or wives have now nicknamed them the "sex machine".

 

[maranatha]

1) If you're celebrating your graduation by dropping acid, it's best NOT to do it at a large state fair with thousands of people, animals, and clowns present.

2) If you're immigrating from the middle east, reporting that the FBI is watching you is NOT a symptom of psychosis.

3) Delirium may be manifested by forgetting you had pizza and beginning to eat the plate.

!!!!!!!!!

 

[Hurricane]

If your business partner allegedly "goes crazy" and does a bunch of drugs down in Mexico, for $15K you can have someone slip something in his drink, nab him, and bring him to a psych hospital, where they will shoot him up the Mexican equivalent of Thorazine, wrap him up in a blanket and duct tape like a burrito, and put him on a helicopter, and drop him off at a hospital in the US, despite the psych intake at said hospital refusing to accept the patient over the phone. And they'll put him on a Versed drip, so that he arrives at your ER quite respiratory depressed with an unprotected airway. However, when he wakes up quite lucid and not psychotic, we will discharge him with our apologies.
-- Lesson #1: Don't go crazy in Mexico.
-- Lesson #2: It's not paranoia if your friends really are out to get you.

And another one:
At the VA, don't be so quick to dismiss a patient's claim that people are after him because he has top secret documents as paranoia. Because one day NCIS might show up (yes, like the TV show, they really exist) asking if said patient ever mentioned where the documents are and if he said anything about the Russians.

 

[Anasazi23]

I think it's a psychiatry residency right of passage to have either the FBI or some other federal body looking for a particular patient or information from a patient that you took care of.

 

[The Pride]

If your business partner allegedly "goes crazy" and does a bunch of drugs down in Mexico, for $15K you can have someone slip something in his drink, nab him, and bring him to a psych hospital, where they will shoot him up the Mexican equivalent of Thorazine, wrap him up in a blanket and duct tape like a burrito, and put him on a helicopter, and drop him off at a hospital in the US, despite the psych intake at said hospital refusing to accept the patient over the phone. And they'll put him on a Versed drip, so that he arrives at your ER quite respiratory depressed with an unprotected airway. However, when he wakes up quite lucid and not psychotic, we will discharge him with our apologies.
-- Lesson #1: Don't go crazy in Mexico.
-- Lesson #2: It's not paranoia if your friends really are out to get you.

And another one:
At the VA, don't be so quick to dismiss a patient's claim that people are after him because he has top secret documents as paranoia. Because one day NCIS might show up (yes, like the TV show, they really exist) asking if said patient ever mentioned where the documents are and if he said anything about the Russians.

I NEVER thought I would miss Parkland, much less the Psych ER, but that's awesome.

 

[Anasazi23]

If you walk to 3 different pharmacies, collecting various bottles of over-the-counter sleeping aids, and take over 6g of diphenhydramine mixed with all sorts of unknown chemicals and melatonin, wash it down with a liter of vodka, remain in a coma for 2 days until you're luckily found by a friend after you text messaged them that "your friendship meant a lot, and goodbye," don't act agitated and surprised when I admit you to psychiatry from the ICU. It's just the way it is.

 

[Hurricane]

I NEVER thought I would miss Parkland, much less the Psych ER, but that's awesome.

Believe it or not, that was at Presby, not Parkland

 

[MBK2003]

If you walk to 3 different pharmacies, collecting various bottles of over-the-counter sleeping aids, and take over 6g of diphenhydramine mixed with all sorts of unknown chemicals and melatonin, wash it down with a liter of vodka, remain in a coma for 2 days until you're luckily found by a friend after you text messaged them that "your friendship meant a lot, and goodbye," don't act agitated and surprised when I admit you to psychiatry from the ICU. It's just the way it is.

And if you slap me after I tell you that you're being admitted to psychiatry, you can bet on the fact that I'll be smiling the whole time I'm writing your involuntary commitment paperwork.

MBK2003

 

[Anasazi23]

If I'm called to the tele unit to come assess your capacity to sign out AMA at 3am, and am greeted by you surrounded by security, and if you raise your cane to me in a threatening manner and invoke muhammad to rebuke me if I don't get out of your way, it does little to help your case.

 

[Doc Samson]

After willingly volunteering to be a patient for the NBME oral board exam, it's really helpful to threaten to shoot the examinee and then try to leave the room within the first 5 minutes of the interview. It really helps make the examinee feel like it really is just another ER interview.

 

[milesed]

The level of obesity/days without a bath/verbal abusiveness is directly proportional to their likelihood to vomit/urinate/defecate/ masturbate on or near you.

 

[Ibid]

A lot.... a lot of pent up aggression on display here.....

 

[MacDonaldTriad]

When triage sends you a Latin male patient because he is stridoring and says that Jesus is inside of him and will not let him breath, don’t forget to get neck films and a CXR. Sometimes he might have a Rosary Cross stuck on his carina.

 

[OldPsychDoc]

Ahh memories...the Golden Age of SDN Psychiatry...

 

[Ibid]

When triage sends you a Latin male patient because he is stridoring and says that Jesus is inside of him and will not let him breath, don’t forget to get neck films and a CXR. Sometimes he might have a Rosary Cross stuck on his carina.

This is a good read... http://en.wikipedia.org/wiki/The_Three_Christs_of_Ypsilanti

""The Three Christs of Ypsilanti" is more than the record of an experiment in the outermost reaches of social psychology. Among other things it represents, in an unpretentious but remarkably vivid way, what institutionalized madness is like."-Steven Marcus, "The New York Review of Books""A rare and eccentric journey into the madness of not three, but four men in an asylum. It is, in that sense, an unexpected tribute to human folly, and one that works best as a meditation on our own misplaced self-confidence. Whether scientist or psychiatric patient, we assume others are more likely to be biased or misled than we are, and we take for granted that our own beliefs are based on sound reasoning and observation. This may be the nearest we can get to revelation--the understanding that our most cherished beliefs could be wrong."

Ahh memories...the Golden Age of SDN Psychiatry...

I'm going to start bringing up my old threads.....

 

[Daedra22]

Snorting bupropion is not an appropriate substitute for snorting cocaine. It will only give you seizures.

 

[MacDonaldTriad]

A vary old one this morning, but advice none the less. When you are in the Medicine ER and are withdrawing from ETOH, after you have espoused elaborate plans to enter into detox and negotiated for a bed to “please just let me stay long enough to get into my program on Monday”, and after explaining how “I need to do this to get my kids back”, be sure and run outside for a cigarette and keep going. Then we need to be ready to defend our decision to take the person off of involuntary status to the ER attendings because after all we all know how infinite our powers of motivational interviewing are.

 

[Ceke2002]

I've learnt many fascinating things from fellow patients patients over the years, including the fact that Ferrari apparently manufactures a car that changes colour depending on what speed you're going, injecting amphetamines into your eye makes total sense if you can't get a vein anywhere else, if you're the official Papal anointed second coming of Christ it's perfectly feasible that you would also be the head of the Mafia...Oh, and I'm an incarnate Goddess (although they were never quite clear on exactly which one).

 

[Therapist4Chnge]

When attempting to leave AMA….do not threaten harm via a historical figure time-traveling to administer a beating.

 

[MacDonaldTriad]

If you are being arrested for a DUI and the officer asks you if you are suicidal, always say yes. They will take you to the nearest ER and the watch commander of the next shift will never bother to send anyone to book you the next morning.

 

[stsa84]

If you see your friend pulled into a meat processing machine, you're gonna have a bad time.

 

[Extralong]

1) If you're celebrating your graduation by dropping acid, it's best NOT to do it at a large state fair with thousands of people, animals, and clowns present.

2) If you're immigrating from the middle east, reporting that the FBI is watching you is NOT a symptom of psychosis.

3) Delirium may be manifested by forgetting you had pizza and beginning to eat the plate.

Making a written contracted loan repayment program with your cocaine dealer will probably not pan out well.

 

[Ceke2002]

The other week I learnt that Pacific Rim is a really amazingly awesome film. So amazingly awesome in fact, that one must attempt to re-enact the entire movie in the middle of a clinic's waiting room, for the benefit of those who are yet to witness it's amazing awesomeness.

 

[whopper]

Wait half an hour after you eat a marijuana brownie for the drug effects.
Well I already knew that.
But the person who did not wait told me she put enough marijuana in the brownies she made to get dozens of people high because she was planning on serving it at a party. After she took a brownie to test it, and didn't get high, she took antoher, didn't get high, then took another, and within about 15 minutes ate all the brownies she made.

For the next 1.5 weeks she was stoned. She couldn't get out of bed for a few days straight.

I was thinking of writing that experience down in a humorous novel someday, but turned out that the Wolf of Wall Street had a very similar experience with Quaaludes.

 

[Ceke2002]

Wait half an hour after you eat a marijuana brownie for the drug effects.
Well I already knew that.
But the person who did not wait told me she put enough marijuana in the brownies she made to get dozens of people high because she was planning on serving it at a party. After she took a brownie to test it, and didn't get high, she took antoher, didn't get high, then took another, and within about 15 minutes ate all the brownies she made.

For the next 1.5 weeks she was stoned. She couldn't get out of bed for a few days straight.

I was thinking of writing that experience down in a humorous novel someday, but turned out that the Wolf of Wall Street had a very similar experience with Quaaludes.

This reminds me of my ex who chomped his way through three times the amount of dope cookies he'd actually been advised to take, and then topped it off with a packed two hit of Skunk when the cookies weren't taking effect fast enough. First time I've ever seen anyone literally projectile vomit clear across a room. He ended up getting me to call the Poisons Control info line.

 

[milesed]

If admitting 3 psychotic patients on Friday who all say they are God, they will work it out by Monday as the Father, Son and Holy Spirit.

 

[OldPsychDoc]

If admitting 3 psychotic patients on Friday who all say they are God, they will work it out by Monday as the Father, Son and Holy Spirit.

What if one of them is Unitarian? Or Muslim?

 

[milesed]

Then call security because it's Armageddon time!

 

[kugel]

The level of obesity/days without a bath/verbal abusiveness is directly proportional to their likelihood to vomit/urinate/defecate/ masturbate on or near you.

You say that like it's a bad thing.

 

[whopper]

Don't put 3 Jesuses in the same therapy group.

They'll end up punching each other because I guess only a slugfest could determine the real Jesus.

 

[Therapist4Chnge]

I wonder if it started over an argument about who's Father could win in a fight?

 

[wolfvgang22]

Don't put 3 Jesuses in the same therapy group.

They'll end up punching each other because I guess only a slugfest could determine the real Jesus.

And from what I've seen, the Jesus that wins will be a skinny, balding 60 year old black man with gold teeth who came in wearing a black T-shirt emblazoned with large Gothic gold lettering reading:
"He Layeth The Smack Down"

 

[OldPsychDoc]

"Sic 'em, Jesus."

 

[EpiIV]

Crushing your extended release anti-psychotics and snorting them is not an effective mechanism of delivery.

 

[milesed]

Same^ goes for the nurse injecting only the diluent of a Consta shot.

 

[PikminOC]

Lunesta or Ambien can cause an otherwise normal person to wake up in the morning and discover that they had made enough mushroom enchiladas in the middle of the night to choke horse, which can be verified by a pile of half-eaten enchilada shrapnel left in the bed and a very messy kitchen.

Zyprexa too. But they are awake.